Transcranial Doppler ultrasonography predicts cardiovascular events after TIA

• Published in: BMC medical imaging 2009-07, Vol.9 (1), p.13-13, Article 13
• Main Authors: Holzer, Katrin, Sadikovic, Suwad, Esposito, Lorena, Bockelbrink, Angelina, Sander, Dirk, Hemmer, Bernhard, Poppert, Holger
• Format: Article
• Language: English
• Subjects: Atherosclerosis; Blood pressure; Cardiac arrhythmia; Cardiovascular disease; Cardiovascular diseases; Cerebral blood flow; Comorbidity; Complications and side effects; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Diabetes; Diagnosis; Doppler effect; Family medical history; Female; Germany - epidemiology; Health aspects; Heart attack; Humans; Hypertension; imaging; Incidence; Ischemia; Ischemic Attack, Transient - diagnostic imaging; Ischemic Attack, Transient - epidemiology; Male; Middle Aged; Multivariate analysis; Myocardial infarction; Myocardial Ischemia - diagnostic imaging; Myocardial Ischemia - epidemiology; Neurology; NMR; Nuclear magnetic resonance; Patient outcomes; Prognosis; Reproducibility of Results; Risk Assessment - methods; Risk Factors; Sensitivity and Specificity; Stenosis; Stroke; Transcranial Doppler ultrasonography; Transient ischemic attack; Ultrasonic imaging; Ultrasonography; Ultrasonography, Doppler, Transcranial - statistics & numerical data; Ultrasound
• ISSN: 1471-2342; 1471-2342
• DOI: 10.1186/1471-2342-9-13

Transient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA. 176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of 27 months, new vascular events were recorded. 22 (13.8%) patients experienced an ischemic stroke or TIA, 5 (3.1%) a myocardial infarction or acute coronary syndrome, and 5 (3.1%) underwent arterial revascularization. ECD revealed extracranial > or = 50% stenosis or occlusions in 34 (19.3%) patients, TCD showed intracranial stenosis in 15 (9.2%) and collateral flow patterns due to extracranial stenosis in 5 (3.1%) cases. Multivariate analysis identified these abnormal ECD and TCD findings as predictors of new cerebral ischemic events (ECD: hazard ratio (HR) 4.30, 95% confidence interval (CI) 1.75 to 10.57, P = 0.01; TCD: HR 4.73, 95% CI 1.86 to 12.04, P = 0.01). Abnormal TCD findings were also predictive of cardiovascular ischemic events (HR 18.51, 95% CI 3.49 to 98.24, P = 0.001). TIA patients with abnormal TCD findings are at high risk to develop further cerebral and cardiovascular ischemic events.